Medical Insurance Claims Manager - Remote | WFH

Are you passionate about leading teams and driving excellence in the medical insurance claims process? We are looking for a dynamic and experienced Medical Insurance Claims Manager to join our team! In this role, you'll oversee the Claims department (with two direct reports), ensuring timely and accurate claim submissions, prompt reimbursements, and resolution of claim rejections and denials, all while maintaining compliance with insurance regulations and policies. You'll work closely with our funding operations and finance teams to drive continuous improvement, enhance productivity in Salesforce and other tools, and elevate the customer experience.

This position offers flexibility - you can choose to work fully remote or hybrid! The base salary ranges from $95K to $105K, plus bonuses and an Employee Stock Ownership Plan (ESOP). This is a direct hire position with full benefits!

Key Responsibilities

Lead the Claims department to achieve key performance metrics, ensuring productivity meets or exceeds expectations for both internal and external customers.

Align department objectives with corporate goals and translate broader company strategies into actionable tasks for the Claims team.

Hire, train, and provide daily guidance and coaching to the Claims team, promoting our "Listen, Learn, and Lead" philosophy.

Identify and recommend technical solutions to improve response times and accuracy.

Collaborate with Medical Funding staff to ensure a successful funding process, focusing on continuous improvement and compliance with HIPAA and FRPA regulations.

Collect and maintain data to ensure the integrity of medical information for process improvement and audits.

What We're Looking For

7-10 years of experience managing a claims department, with in-depth knowledge of medical funding and insurance processes.

Demonstrated excellence in team management and leadership, with the ability to guide and grow a team (this role has two direct reports with growth projected in the near future).

Strong analytical skills with the ability to interpret and utilize data to drive business strategy.

Proven ability to collaborate cross-functionally with a focus on continuous improvement and achieving optimal outcomes.

Bachelor's degree in business, healthcare management, or a related field.

We are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We also consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.

If you're ready to make a significant impact and be part of a supportive and forward-thinking team, we'd love to hear from you!

Employment Type: Full-Time